Chipped Porcelain Crowns and Veneers

 

You’ve spent lots of money on some cosmetic dental work maybe 3 or 4 years ago. Now you’ve done something a little stupid like holding a sewing needle between your teeth, or maybe a fishing lure. The end result is that you’ve chipped some of the porcelain off.

It is still possible that you may have to replace your crown. However, there are products on the market which the dentist can use to repair the porcelain with composite (white filling material) which can be polished and hold up for an unknown period of time (depending on how much wear you put on the teeth).

One of the traditional products uses a 9% hydrofluoric acid porcelain etchant (this etches the porcelain so that the surface of the porcelain can accept the bonding materials and have them bond to each other) followed by a Silane product which treats the porcelain for enhanced bonding to it. Once these materials are placed the dentist will continue using bonding agents and filling materials just like he would if he were repairing a natural tooth. The unpopular part about this is that dentists don’t like to put hydrofluoric acid in the mouth because it’s pretty toxic. A rubber dam is frequently used to isolate the tooth.

The Kerr company has a material called Kerr Vertise which is a flowable composite with contains an etchant in the formulation which enhances the bond. I haven’t tried it but the kit was a bit pricey for a product that I won’t use that often.

I will be trying a material that was recommended to me from a reliable source: Fast Fix from the CAO group. It is a simpler to use product (always a favorite for dentists) where Fast Fix liquid is applied to the roughened porcelain (it has an organic acid and silane combined into 1 step) and then the filling material can be placed. The goal of course is to get the filling material to stay and look polished for as long as possible.

Patients may not realize that a porcelain repair may well not last forever. An opinion leader in dental materials, Dr. Gordon Christensen, tells his patients that a repair is temporary. That’s just the way it is.

A few things to keep in mind when repairing porcelain: if you lose a big chunk of porcelain it is less likely to be a successful repair. If you broke the porcelain in an area with great chewing force it is also more likely not to be reparable. The usual solution is to have the crown made out of a material that doesn’t have any porcelain to fracture at the point of heavy occlusion (where you bite down very hard). This part is usually made out of zirconium (a white metal) or a traditional metal alloy which is not tooth colored (this usually wears the opposing tooth less which the dentist prefers). So as you can see, there are different choices and always new choices for repairs when it comes to dental materials.